Ask Dr. Pane! I had a breast lift and my scar is horrible. Would you suggest cutting again to fix that?

Question: Would you suggest cutting again to fix a bad breast surgery scar?

At Atlantic Coast Aesthetics, we get many questions from patients who are understandably unhappy with the outcomes of previous cosmetic surgery such as breast augmentation surgeries, and especially with the visibility or profile of the scar tissue inevitably left behind after a cosmetic procedure. This is especially true in cases where medical professional who are not board certified cosmetic surgeons perform the procedures. Sometimes these cases may be a little trickier than usual, first because we almost certainly didn’t do the original procedures and so are walking into the middle of the story, so to speak, and second because every patient and thus every scar revision is a little different.

One example of this is the focus of this question from a recent Instagram Live session, where Dr. Thomas Pane, our founder and Chief Medical Officer, addressed patient questions before a live Internet audience. The patient asked, “I had a breast lift and my scar is horrible. Would you suggest cutting again to fix that?” Here’s what Dr. Pane had to say about this case!

“I hope we didn’t do it! Usually someone needs to be at least six months out from the original surgery. Then typically these scars can be revised.”  This is to give the incision sites time to heal fully so we can get a good sense of what direction the scarring is taking.

Scars are an inevitable part of the healing process. Usually, these scars fade over time until they’re barely noticeable. However, the type of surgery which was performed initially will have a direct impact on the sort of scarring the patient should expect. For example, having breast implants removed along with a capsular contracture procedure where the void left by the implant is reduced or modified surgically, or breast reduction surgery where the remaining loose skin is excised, will often leave different scar profiles than a bilateral mastectomy or “double mastectomy,” as it’s known in layperson’s terms, where most or all of the breast tissue is removed from the chest wall. Tattoo removal also leaves scars just like the tattooing process itself, but these tend to be less noticeable. In some patients, their bodies tend to deposit excess collagen into the area in an effort to rebuild the compromised tissue, leading to hypertrophic scar tissue, where the scar profile is elevated above the surrounding skin and may have an uneven appearance. In extreme cases, these are known as “keloids.”

Dr. Pane notes, “If the breast lift was done and it was under a reasonable amount of tension and it didn’t heal like a regular wound, your body’s going to have a tendency to make a wider scar  So now that the lift is all healed and everything’s fine, you can sometimes come back, take out the scar, re-close it and now there’s less tension on it because the lift has already been done.”

Dr. Pane also reiterates the importance of aftercare and following the advice of your plastic surgeon and clinical staff. “After the scar is removed, do really strict taping and the other things I recommend on it to make sure it heals properly and that the scar doesn’t have any chance to expand. For people who have a hard time healing, if the incision opens up, there could be a bit of a wide scar in that zone and if it doesn’t contract out or flatten after six months to a year, it’s usually not a big deal to do a scar revision. Not everyone wants it done because usually it heals really well, but it’s not a problem.”

It’s typical after surgery, and especially scar revision surgery, to experience temporary loss of feeling or a burning sensation. The burning sensation is usually mild and tapers off after several days. Most patients are unlikely to notice because the pain medications given during and after surgery will mute it to background noise. However, if you do notice unusual or intense pain, muscle spasms, lymph node swelling or burning in the area, or anything else which just doesn’t look or feel quite right, contact your cosmetic surgeon or the healthcare professionals on their team immediately! We’d rather deal with a hundred false alarms than miss one potentially very serious side effect.

To get the best possible results for any cosmetic surgery from botulinum toxin injections to brow lift to hand surgery or vaginal rejuvenation, we recommend you look for board-certified plastic surgeons who are accredited by both the American Society for Aesthetic Plastic Surgery and the American Society of Plastic Surgeons. This can help you ensure you’re getting the best possible care, whether you’re doing something very simple or need complex multiple procedures.

Atlantic Coast Aesthetics is committed to giving honest, real patient information and setting reasonable expectations for your cosmetic surgery journey. While we don’t have a newsletter sign-up, we invite you to follow us on Facebook, Instagram, LinkedIn and Twitter; call us at (561) 422-4116; or email us at acplasticsurg.com/contact-us/. Your question may become the focus of an upcoming Ask Dr. Pane segment or Instagram Live chat, helping us inform and educate others while giving you the straight talk you need to make the best possible decisions for your desired outcomes. Remember, at ACA we believe the only bad question is the one you DON’T ask!